PURPOSE: To tabulate underlying disease and to assess the clinical significance of CT-diagnosed spontaneouspneumonediastinum. MATERIALS AND METHODS: We retrospectively reviewed CT scans and medical records of 11consecutive patients with spontaneous pneumomediastinum, and analyzed their clinical history and course, and infive cases, pulmonary function. CT scans of 126 patients with idiopathic pulmonary fibrosis (IPF) collected whilethe 11 consecutive patients were being treated were analyzed for the prevalence of pneumomediastinum. We analyzedCT findings with respect to the amount and distribution of air in the mediastinum, and the presence or absence ofair outside the mediastinum. RESULTS: In the 11 patients, underlying diseases were IPF (n=4), bronchiolitisobliterans organizing pneumonia (BOOP)(n=2), bronchiectasis (n=2), tuberculous tracheal stenosis (n=1), andpulmonary tuberculosis with bullous emphysema (n=1); there was one without associated disease. Of the 126 patientswith IPF, four (3.2%) showed spontaneous pneumomediastinum. All ten with underlying diseases had severe dyspnea.In five patients, a pulmonary function test showed marked impairment. Two of four patients with IPF and both withBOOP died within 2 months of CT scanning, whereas the remaining six showed clinical improvement. The detectionrate of pneumomediastinum on plain chest radiograph was 82% (9/11). CT showed that mediastinal air was mostfrequently found in the retrosternal space. There were four cases of pneumothorax and two of subcutaneousemphysema. CONCLUSION: Spontaneous pneumomediastinum might be associated with idiopathic pulmonary fibrosis andmight be a poor prognostic factor in patients with IPF or BOOP.
Bronchiectasis ; Cryptogenic Organizing Pneumonia ; Emphysema ; Humans ; Idiopathic Pulmonary Fibrosis ; Mediastinal Emphysema* ; Mediastinum ; Medical Records ; Pneumonia ; Pneumothorax ; Prevalence ; Radiography, Thoracic ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Tracheal Stenosis ; Tuberculosis

Pseudocyst of the scalp is described in the Japanese literature as a skin-colored cystic tumor localized on the forehead, whereas alopecic and aseptic nodules of the scalp are described in the French literature as asymptomatic nodules on the scalp that lack a pseudocyst-like architecture. The etiology of these diseases is unknown, but the lesions are likely due to follicular occlusion. Here, we report a case of pseudocyst of the scalp in a 72-year-old woman. The patient had a dome-shaped painless tumor on her scalp. Histologic examination showed a pseudocyst-like architecture with no true cystic wall. Here, we report a case of pseudocyst of the scalp and summarize the characteristic features of both pseudocyst of the scalp and alopecic and aseptic nodules of the scalp.
Aged ; Asian Continental Ancestry Group ; Female ; Forehead ; Humans ; Scalp

Ectopic ossification refers to the process of new bone formation in sites that normally do not ossify. The auricle is composed of elastic cartilage, and hence is a pliable structure. Auricular ossification is a rare condition that might be caused by injurious processes, including frostbite, physical trauma, and inflammation as well as processes related to metabolic or endocrine disorders. Here, we report a case of unilateral auricular ossification in a 53-year-old Korean man who had previously rubbed his ear repeatedly with his hand.
Cartilage ; Ear ; Elastic Cartilage ; Frostbite ; Hand ; Humans ; Inflammation ; Middle Aged ; Ossification, Heterotopic ; Osteogenesis

BACKGROUND: Moisturizers are commonly used for the management of many skin problems and sometimes they are used to maintain healthy skin. Previous studies on the short-term treatment with moisturizers have shown that moisturizers can weaken or strengthen the skin barrier function. OBJECTIVE: We evaluated the effect of long-term treatment with a physiologic lipid-containing moisturizer on the barrier function of normal skin. METHODS: 39 healthy volunteers applied the moisturizer on one forearm 3 times daily for 8 weeks and then they were followed-up for the next 2 weeks (the regression period). No moisturizer was used on the other forearm as a control. The TEWL, skin capacitance and skin lipid content were evaluated weekly during the 8 weeks treatment period and then daily during 2 weeks of the regression period. RESULTS: During the treatment period, the skin capacitance and lipid content values of the treated side were significantly higher than that of the control side, and the TEWL values of the treated side were significantly lower than that of the control side. During the regression period, all the values of the treated side steadily became closer to those of the control side. These results suggest that long term treatment with moisturizer does not deteriorate the skin barrier function. CONCLUSION: Long-term treatment with moisturizer containing physiologic lipid not only enhances the normal skin barrier, it does not suppress the endogenous lipid synthesis of the skin.
Forearm ; Skin

BACKGROUND: Moisturizers are commonly used for the management of many skin problems and sometimes they are used to maintain healthy skin. Previous studies on the short-term treatment with moisturizers have shown that moisturizers can weaken or strengthen the skin barrier function. OBJECTIVE: We evaluated the effect of long-term treatment with a physiologic lipid-containing moisturizer on the barrier function of normal skin. METHODS: 39 healthy volunteers applied the moisturizer on one forearm 3 times daily for 8 weeks and then they were followed-up for the next 2 weeks (the regression period). No moisturizer was used on the other forearm as a control. The TEWL, skin capacitance and skin lipid content were evaluated weekly during the 8 weeks treatment period and then daily during 2 weeks of the regression period. RESULTS: During the treatment period, the skin capacitance and lipid content values of the treated side were significantly higher than that of the control side, and the TEWL values of the treated side were significantly lower than that of the control side. During the regression period, all the values of the treated side steadily became closer to those of the control side. These results suggest that long term treatment with moisturizer does not deteriorate the skin barrier function. CONCLUSION: Long-term treatment with moisturizer containing physiologic lipid not only enhances the normal skin barrier, it does not suppress the endogenous lipid synthesis of the skin.
Forearm ; Skin

A 28-year-old Asian male was referred for dermatologic evaluation of diffuse bluish-red maculopapules in the lower trunk and genital regions. There was no family history, and with the exception of dispersed skin lesions and hypohidrosis, no other complaints or symptoms were present. Histological evaluation of the skin lesions revealed angiokeratomas. When this combination of clinical and histological findings is observed, Fabry disease is suspected. Biochemical examination performed for definitive diagnosis did not show any activity of the alpha-galactosidase A enzyme. Through identification of a c.182_183ins(GA) mutation of the GLA gene, Fabry disease was diagnosed. However, there was no particular abnormal finding with regard to the evaluation of non-cutaneous manifestations, a symptom that can occur in the progress of this disease. We reported a case of Fabry disease, restricted to the dermatologic presentation, involving a novel frameshift mutation in the GLA gene.
alpha-Galactosidase ; Angiokeratoma ; Asian Continental Ancestry Group ; Fabry Disease ; Frameshift Mutation ; Humans ; Hypohidrosis ; Male ; Skin ; Skin Manifestations

A 28-year-old Asian male was referred for dermatologic evaluation of diffuse bluish-red maculopapules in the lower trunk and genital regions. There was no family history, and with the exception of dispersed skin lesions and hypohidrosis, no other complaints or symptoms were present. Histological evaluation of the skin lesions revealed angiokeratomas. When this combination of clinical and histological findings is observed, Fabry disease is suspected. Biochemical examination performed for definitive diagnosis did not show any activity of the alpha-galactosidase A enzyme. Through identification of a c.182_183ins(GA) mutation of the GLA gene, Fabry disease was diagnosed. However, there was no particular abnormal finding with regard to the evaluation of non-cutaneous manifestations, a symptom that can occur in the progress of this disease. We reported a case of Fabry disease, restricted to the dermatologic presentation, involving a novel frameshift mutation in the GLA gene.
alpha-Galactosidase ; Angiokeratoma ; Asian Continental Ancestry Group ; Fabry Disease ; Frameshift Mutation ; Humans ; Hypohidrosis ; Male ; Skin ; Skin Manifestations

In post-stroke patients, the pain or paresthesia of the affected limb is common. These symptoms may be caused by a variety of pathologic conditions. Considering the debilitating effects of the pain, it is important to determine the exact cause and manage appropriately. A 41-year-old woman who had experienced a hemorrhagic lesion in the right basal ganglia and corona radiata 4 months previously presented with an irritating tingling sensation in her left upper extremity. She failed to respond to a number of treatment options including medications and physical agent modalities. Following a diagnosis of disputed thoracic outlet syndrome (TOS) caused by scalene muscle dysfunctions, she received ultrasound-guided electrical twitch-obtaining intramuscular stimulation (ETOIMS) which significantly alleviated the pain. This case suggests that the disputed TOS should be considered as one of the possible causes of post-stroke pain, and that detailed history-taking and physical examination, as well as imaging or electrophysiological studies, might be required for accurate diagnosis. Furthermore, ultrasound-guided ETOIMS can be used as a safe and minimally invasive technique for the treatment of the disputed TOS with fewer systemic and local side effects.
Adult ; Basal Ganglia ; Diagnosis ; Extremities ; Female ; Humans ; Muscles* ; Paresthesia* ; Physical Examination ; Sensation ; Stroke ; Thoracic Outlet Syndrome ; Upper Extremity*

Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.

OBJECTIVES: Cognitive dysfunction, including inattention, is often observed in patients with depression. Inattentive symptoms in patients with depression is similar to those among attention deficit/hyperactivity disorder (ADHD) patients. It is important to diagnose the two diseases accurately, because the treatment varies depending on the cause of inattention. This study aimed to investigate the coexistence rate of ADHD and the correlation between ADHD symptoms and depression in patients with depression. METHODS: Participants in this study were 158 outpatients presenting with depression, who visited the psychiatric department from March 2015 to July 2018. Participants divided into a depression and a non-depression group according to the Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) score and were administered the following : a sociodemographic variables form (age, sex, academic background, occupation), the self-reporting test for adult ADHD (Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1; ASRS V1.1), and the Korean version of the Connors adult ADHD rating scale (K-CAARS). Descriptive statistical analysis, crossover analysis, t-tests, and Pearson's correlation coefficient were conducted on the data. RESULTS: The coexistence rate of adult ADHD symptom was as high as 36.7% in patients with depression (p<0.001). In K-CAARS, the depression group (Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06) showed higher average scores on ADHD symptoms than the non-depressive group (Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42, p<0.001). CONCLUSIONS This study confirmed that ADHD symptoms coexist in the depression group. When evaluating the symptoms of patients who complain of depression, it is suggested that they should be accurately diagnosed and appropriately treated with interest to the coexistence of ADHD symptoms and the possibility for ADHD diagnosis.